Saturday, March 27, 2010

Where Is The Health Coverage Of Yesteryear?

I want to add a personal coda to the madness we've witnessed in the last 14 months that culminated in the spitting, the racist and anti-Gay epithets, and the rocks flying through the windows of Democrats.

The year was 1970, 40 years gone now, and I was in college. Throughout that summer I worked a unionized construction job digging ditches, tearing apart concrete forms for huge skyscrapers and stacking and re-stacking lumber and other supplies.

My father had died the previous summer. Because I was a full-time college student, I was automatically enrolled in a plan for medical coverage under Medicare/Medicaid due to his death. (Coverage #1)

I also remained on our family health insurance, because I was still in college, a matter of a couple of dollars a month. (Coverage #2)

Additionally, like most colleges, mine folded health coverage into the usual tuition and fees. (Coverage #3)

In order to join the laborers local brotherhood for my summer job, I had to pay a very small portion of yet another health insurance plan. I believe my share was 15% of my overall plan cost, which came to less than 50 cents per week. I can't remember the exact percentage, but it was painless. I had to maintain the payments the whole year long if I wanted to work the following summer, which I did. (Coverage #4)

I never used one jot of the insurance, even though the union plan allowed for two free extensive check ups through their chosen network. The paperwork was a bit onerous, I was an impatient adolescent, and besides, my own family doctor charged a measly $7.50 for the mandatory back-to-school physical, a 15-minute once over with a couple of shots. (Prices from the New York metropolitan area.) It was much simpler to take it out of my own earnings in order to go to the doctor I had grown up with and liked very much.

I know there are some, especially the young, who might want to paint me as a "golden-ager," living an American version of "La vie en rose." I'm really not. Looking back, there are many things from that era that were demeaning and completely irrational. And I was a white middle class male, so you can imagine what others were enduring.

Health care was not one of those things that was completely irrational. I'm not just outraged, I'm consistently surprised at what has gone on with health care costs over four to four and a half decades.

Since 1965, real wages have gone up about 40% in the United States. Some things cost a lot more, but most things have remained quite stable. For instance, gasoline in 1965 was approximately $2.15 per gallon in constant dollar terms. In November of 2009 it was $2.61, a real rise of 22%. A loaf of bread cost about 39 cents, whereas now it costs about $1.49. (Stop thinking high end baguettes and boules!)

Health care has risen from 7.2% of GDP in 1965 to over 18% of GDP today, and it is projected to be 20 to 22% of GDP just 5 years from now.

Like most of us, I don't know how wonderful the Democratic Party's reform will be. I do know that when I look at the arc of my own life and those of my contemporaries vis a vis the old days and today, health care looks pretty good back then.

Was medical treatment as thorough? No, of course not. Innumerable advances have been made. Was it equitably distributed? No, it was not, but it isn't now and probably won't be in the future, either.

Is it worth 22% of our national income to get us to 85 or 90 instead of 77?